To assess the therapy of spontaneous pneumothorax in the aged patients, the treatment methods and results in 60 patients 50 years of age or older were retrospectively reviewed. Most of the patients were male(56 of 60 patients) and the major
underlying
lung diseases associated with spontaneous pneumothorax were tuberculosis(32 patients) and chronic obstructive lung disease(20 patients). The recurrence rate of thoracostomy tube drainage with or without chemical pleurodesis using tetracycline was
39.6%
(21 of 53 patients) but there was no recurrence in the patients treated with open thoracotomy, pleural abrasion, and chemical pleurodesis using talcum powder(Asbestosis free). In the patients treated with open thoracotomy, the bullous or bleb
lesions
were placed in the various sites of both lungs. We concluded the even though thoracostomy tube drainage is the first choice of therapy for spontaneous pneumothorax in the aged patients, the recurrence rate is high, especially in the patients with
persistent air leakage for more than 2 days, and the open thoracotomy with pleural abrasion and chemical pleurodesis using talcum powder can prevent the recurrence in the selected patients. (Korean J Thoracic Cardiovas Surg 1994; 27:532-7)
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